Clinical Health Psychology

Books in APA Books’ Clinical Health Psychology Series offer comprehensive but concise overviews of practice in specific areas of clinical health psychology, such as integrated primary care, women’s reproductive health, cardiology, oncology, and pain management. Each book in the series is intended specifically for mental and behavioral health professionals who are new to that field.  Here are the currently available books in the series:

Psychological Treatment of Patients With Cancer (September 2017)

Ellen A. Dornelas

This volume describes a range of psychological interventions aimed at helping patients cope with cancer treatment. Chapters describe assessment and treatment of common problems including depression, anxiety, fatigue, sexual dysfunction, and cover broader themes in cancer care including the impact on families.

 

 

 

Psychological Treatment of Medical Patients in Integrated Primary Care (September 2017)

Anne C. Dobmeyer

This book provides an overview of integrated primary care for mental health professionals. It describes the benefits and key components of integrated care, with a special emphasis on the Primary Care Behavioral Health model of service delivery. Guided by competencies developed by the American Psychological Association and the Agency for Healthcare Research and Quality, clinicians learn to work within a larger team to effectively treat a wide range of chronic medical conditions, behavioral health disorders, and unhealthy lifestyle behaviors that commonly present in primary care patients.

 

Psychological Treatment of Cardiac Patients (December 2017)

Matthew M. Burg

This volume introduces mental health practitioners to cardiovascular behavioral medicine. Matthew Burg reviews fundamental information about the etiology and medical treatment of chronic heart disease, providing a foundation from which readers can learn to assess and treat cardiac patients. In addition to surveying methods and strategies for addressing comorbid psychological disorders, Burg describes how psychologists can help clients adjust to their conditions, change unhealthy behaviors, cope with invasive medical procedures, build social support networks, and face end-of-life issues.

Understanding Violent Men

In June, 2017, APA Books published a special, 25th Anniversary Edition of Violent Men: An Inquiry into the Psychology of Violence, by Hans Toch.  This book first grew out of pioneering studies Toch undertook with police offers, corrections officers and prisoners in the late 1960s.  Later editions arrived in 1992 and now 2017.  Each iteration of the book has coincided with eras in which acts of public violence were a matter of widespread concern and debate, from the urban riots in the ‘60s, to the Rodney King beating and aftermath in the early 1990s, to the recurrent shootings, captured and disseminated today thanks to cellphone videos, of unarmed black men and women by police.  Over the years, Toch’s work has helped illuminate and explain how these and similar violent encounters develop—what perpetrators and victims are thinking, why they are thinking it, and what can be done to stop the violence from occurring.

The impact of Toch’s original book cannot be overstated. It essentially invented criminology as a field of study, and endures today as the ultimate demonstration of how applied psychology can help improve people’s lives.

In his Foreword to this new edition, Series Editor Shadd Maruna explains:

The genius of the work obviously begins with its innovative methodology. In Violent Men, Toch pioneers a methodology that has now become known as “peer interviewing” but at the time of publication surely contradicted every known rule of research and common sense—with prisoners interviewing prisoners, parolees interviewing parolees, and policing veterans interviewing police officers. All of these groups were also involved in the analysis of the qualitative data as it emerged as well. (xiii)

In his Foreword to the 1992 edition—reprinted in the new 25th Anniversary Edition—Bertram Karon writes that Toch’s idea sprang from the recognition that

…both “scientific” investigators and violent individuals understand things, but not the same things, and have biased perceptions, but not the same biases. Furthermore, he knew that people talk openly to people like themselves, but that they do not talk openly to people whom they perceive as likely to look down on them. (xvi)

Toch’s method was useful in ways that went far beyond devising and conducting successful experiments. The book’s practical value is so widespread that it has been used and recommended not just by psychologists, but also social workers, parole and probation officers, juvenile workers, and ward staffs across the world.  Perhaps most importantly, according to Karon:

[Toch’s] technique of including violent individuals in the collaborative study of their own and others’ violence turned out to be a potent technique not only of gathering information and insight but also of enabling violent individuals to understand and master their [own] violence. (xvi)

The implications are profound. As Maruna says, Toch’s work enables

 …even the most disquieting acts of violence become intelligible, even understandable. The book achieves, then, what all great social psychology should strive to do: allow the reader to walk in the shoes of the other and experience the world from their vantage point.  With a title like Violent Men, one might expect (even hope for?) a salacious journey into the deranged mind and cold heart of the “other.” Toch’s readers instead leave the book with just the opposite experience, finding they might have learned more about themselves in the book than about mythological superpredators. (xiii)

To purchase this book or adopt it for a course, click here.

Resources

Toch, H. (2017). Violent Men: An Inquiry Into the Psychology of Violence, 25th Anniversary Edition.  Washington, DC: APA Books.

               

 

 

Accepting Anxiety: Worries Can Be Helpful

By Jessica Jeffers

Your mind is racing. You have trouble sleeping or concentrating. Maybe you’re nauseous or your heart palpitates. You’re worried about everything, no matter how big or how small. As anyone who experiences anxiety can tell you: it’s not fun.

Anxiety disorders are among the most common mental illnesses in the United States. The National Institute of Mental Health reports that 40 million American adults are affected—that’s nearly 18% of the adult population. Anxiety disorders come in many different forms, but they all involve excessive amounts of worry.

One thing that’s easy for many people to forget is that anxiety is actually normal–in small doses. As Bret A. Moore describes in his book Taking Control of Anxiety, many people come to therapy with the unrealistic expectation that they can be rid of their worries entirely. “Trying to eliminate anxiety from your daily experience will leave you feeling frustrated and defeated,” Moore points out. “The key is [to learn] how to manage your anxiety through self-regulation, understanding, and acceptance.” Therefore, the goal of therapy typically is to learn techniques for keeping anxiety under control.

Anxiety evolved in humans primarily as a defense mechanism. It alerts us to potential dangers in our environment and encourages us to respond to these dangers. In this way, it’s an important response to potentially life-threatening situations, such as walking down a dark alley at night or encountering a bear while hiking. Worry becomes problematic, however, when it outweighs the actual amount of danger that is present and when it causes disruptions in your life.

Everyone experiences some level of worry about any number of issues. And these worries can serve a variety of functions that can actually be helpful. For instance:

  • Some anxiety can lead to improved performance. If you’re worried about a big test, an important job interview, or leading a presentation, it’s likely that you will study harder or practice more. That preparation could mean that you end up doing better than you otherwise might have.
  • Anxiety can serve as a motivator. Being anxious doesn’t feel good and most people who are experiencing anxiety focus on what they can do to reduce those feelings. This desire can often serve as the catalyst to change behaviors or situations that aren’t working.
  • People who struggle with social anxiety are excessively concerned about what people might think of them. You don’t want this concern to get in the way of building relationships with others or pursuing goals, but at the same time it can help you become more attuned to the other person’s needs or wants.
  • Visible physical responses to anxiety can serve as a means of communication. It can let others know that you aren’t comfortable, that you need help, and signs such as blushing or stammered speech can even indicate attraction to others.

Of course, excessive worrying can also have negative effects, like hesitation, confused thinking, and poor communication. The trick, as Moore puts it, is to find the right balance for you–which isn’t necessarily the right balance for others. Whether you’re doing it on your own or with the guidance of a mental health professional, part of taking control of anxiety involves finding that balance.

 

References

Moore, B.A. (2014) Taking control of anxiety. Washington, DC: American Psychological Association.

National Institute of Mental Health. (n.d.) Any anxiety disorder among adults. Retrieved from https://www.nimh.nih.gov/health/statistics/prevalence/any-anxiety-disorder-among-adults.shtml.

 

What are Microaggressions?

While the term has been around since 1970, Merriam-Webster only recently added “microaggressions” to its dictionary. It’s defined as, “a comment or action that subtly and often unconsciously or unintentionally expresses a prejudiced attitude toward a member of a marginalized group.”  Merriam-Webster uses racial minorities as one example; however any marginalized group is vulnerable to microaggressions.

This January, APA Books released the paperback edition of That’s So Gay! Microaggressions and the Lesbian, Gay, Bisexual, and Transgender Community. In this book, Dr. Kevin Nadal explains how microaggressions affect the lesbian, gay, bisexual, and transgender (LGBT) community. Nadal describes microaggressions as the “New Face of Discrimination.” It has become unacceptable in the present day and age to openly voice and act on discrimination. Because of this, it can be commonplace for Americans in the majority to determine that they are not prejudiced, because they associate prejudice with the more outright forms of discrimination, such as hate crimes. However, they may not realize the ways in which their seemingly innocuous statements and behaviors can subtly harass or insult minorities.

Unlike blatant acts of discrimination, the motivations behind microaggressions are often ambiguous. Nadal uses the example of a White woman alone on an elevator who moves to the side and grabs her bag when joined by an African-American man. Nadal notes that there are several possible explanations for the woman’s action, but regardless of her intention, the man may suffer psychological stress as a result.

What can we do about microaggressions? Nadal gives several recommendations.  One location where microaggressions occur most often is in the workplace. It may be more difficult to confront microaggressions in this environment because of power dynamics and concerns over one’s employment status. It also raises the concern that one won’t be able to prove a microaggression to human resources representatives—or to convince them that such subtle interactions are worth investigating. Therefore, Nadal recommends that workplaces remain open to discussing microaggressions, and incorporating education about them in training and hiring opportunities.

 

References

Nadal, K. L. (2013). That’s so gay! http://dx.doi.org/10.1037/14093-000

Mindful Photography: Finding Presence Through the Lens

By David Becker

Thanks to modern technology, taking photos is such a simple task that we rarely put much thought into it. All we need to do is pull out our phones, point them at something, and quickly snap a photo just by tapping on the screen. And we don’t even have to worry about wasting film, so there’s no need to put a lot of careful thought into making sure we get the photo just right.

Long before digital cameras and smartphones made photography so effortless and convenient, Ansel Adams commented on how easy it is to just go “snap, snap, snap” and take a bunch of photos to quickly capture a memory. However, he advocated a more thoughtful and creative approach. A legendary innovator in artistic photography, Adams pioneered the concept of visualization, which entails seeing your photo in your mind’s eye and “feeling it” before you actually click the shutter. The goal is to capture not just an external event, but also the internal event that occurs in the photographer’s mind as he or she takes the photo. Quoting fellow artistic photographer Alfred Stieglitz, Adams said, “I give [the photograph] to you as the equivalent of what I saw and felt.” His approach resulted in phenomenally beautiful images that continue to evoke strong emotional reactions from their viewers to this day.

Adams’s visualization technique can be seen as a precursor to mindful photography, a meditative exercise developed by psychiatrist and photographer M. Lee Freedman. In her book A Practical Guide to Cultivating Therapeutic Presence, clinical psychologist Shari Geller (2017) offers this exercise as a way to cultivate a greater sense of presence in our daily lives. By presence, Geller means “(a) being grounded and centered in yourself, while (b) feeling deeply immersed in the moment, with (c) a larger sense of expansion or spaciousness” (p. 4). Mindful photography in particular teaches us how to shift from an immersive experience, in which we become cognizant of fine details, to a more expansive awareness of the big picture. It means seeing both the forest and the trees—perhaps even each individual leaf as well.

Black and white image of a lake with snow capped mountains in the background.

In her book, Geller lays out each step of the mindful photography exercise, which can be done with any sort of camera, whether a digital SLR or a mobile phone:

  1. Pause and take three full breaths, feeling your feet on the ground.
  2. Go for a walk, or look around your current space, to find three objects or images: one that you are attracted to, one you have an aversion to, and one you feel neutral about.
  3. Beginning with the first object or image of something you are attracted to, look through your camera’s viewfinder and notice what you see. Be curious about this object. Allow yourself to receive the image rather than looking out at it.
  4. Now either zoom in or move your body physically closer to the object, focusing on one aspect. Notice what is calling your attention to the subject as you zoom in closer.
  5. Now zoom your lens out, or move your body further away from the image. Look and feel, with curiosity, your relationship with this image.
  6. Walk further away and then pause to look at the image with your eyes or the viewfinder.
  7. Now move closer to the image with your body and/or the viewfinder of your camera. How does this image look or feel different or the same? What do you feel in your body as you use the camera or your body movements to see this object from different vantage points?
  8. Repeat this practice with an image of something you feel averse to and something you feel neutral about. Notice how your perspective, feeling, or relationship with the object may change as you see what is present before you from different perspectives. (pp. 187–188)

Like Ansel Adams, the mindful photographer develops a deep connection with his or her subject. This creates a powerful, mind-opening experience for the photographer that is translated into a beautiful image for others to enjoy as well. In capturing the photographer’s internal event, the resulting photo can also cultivate presence in its viewers, especially those who view it mindfully and take the time to really internalize the image.

References

Geller, S. (with Siegel, D. J.). (2017). A practical guide to cultivating therapeutic presencehttps://doi.org/10.1037/0000025-000